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Archive : June 2012

June 29, 2012

More Legal Challenges May Be on the Way for the Affordable Care Act

After months of waiting, the U.S. Supreme Court June 28 ruled that the Patient Protection and Affordable Care Act is constitutional and its implementation can proceed. That should end the legal...

June 29, 2012

It’s High Time for CMS to Streamline Program Integrity Efforts, Hospital Association Says

Duplicate audits from program integrity contractors and an increasing disregard for the medical expertise of physicians are making it essential for CMS to revamp and streamline anti-fraud and...

June 28, 2012

Health Insurers Have Low-Key Reaction to Supreme Court Ruling

Associations that represent health insurers reacted with low-key statements after the U.S. Supreme Court ruled June 28  that the Patient Protection and Affordable Care Act is largely...

June 26, 2012

EHR Systems on the Rise Among Medicare Physicians

Electronic health records got a boost from Medicare physicians in 2011, with 57 percent reporting that they used an EHR system in their primary practice location. The results were included in a...

June 22, 2012

EHRs Are on the Way, But Budgets Are Getting Strained

Hospitals and health systems are making significant progress in setting up electronic health records systems, but money is starting to get tight, KPMG said in a recent poll.

June 22, 2012

Insurers Will Pay $1.1 Billion in Medical Loss Ratio Rebates for 2011

Health insurers will pay $1.1 billion in rebates that will benefit 12.8 million policyholders by Aug. 1, the Department of Health and Human Services announced   June 21. Insurers are required...

June 20, 2012

OIG Says It's Time to Update Provider Self-Disclosures

The OIG is getting set to update the provider self-disclosure protocol, and it’s looking for help from the public. The June 18 Federal Register featured a notice from the OIG asking for recommendations on how best to revise the protocol, which was originally published by the OIG in 1998.  

June 15, 2012

Medicaid Audit Program Faces the Music

Senators were less than pleased with the results of Medicaid’s national audit program, during a subcommittee  hearing I attended this week. The GAO said Medicaid program integrity contractors...

June 13, 2012

NAIC Moving To Limit Stop-Loss Coverage for Small Companies

The National Association of Insurance Commissioners (NAIC), a Kansas City-based organization that represents state insurance regulators, is moving to update its model law governing “stop-loss”...

June 12, 2012

End In Sight for HHS Privacy and Security Pilot Program

An HHS privacy and security audit pilot program is expected to end by December, an HHS Office of Civil Rights official said during a conference I attended last week. OCR began the program in June...

June 12, 2012

Spending on Prescription Drugs and Physcian Services to Rise Under Reform Law, CMS Says

With everyone waiting on the edge of their seats for the U.S. Supreme Court decision on the constitutionality of the health care reform law, the Centers for Medicare & Medicaid Services June 12...

June 7, 2012

Hospital Group Says It’s Time to Simplify Health Care Regulations

Medicare and Medicaid regulations have grown increasingly bulky and burdensome, a hospital trade group recently said, and it’s time for Congress to step in and make things right.  

June 7, 2012

CBO Says Health Spending Eventually Will Slow Even Without Additional Federal or State Action

Health care spending growth continues to outstrip that of the overall economy, but according to a new Congressional Budget Office report I wrote about this week, spending is expected to slow...

June 7, 2012

45 Payers, 75 Practices to Participate in Bonus Payment Demonstration Program to Coordinate Care

Forty-five commercial, federal, and state insurers in seven markets finalized memorandums of understanding with the Centers for Medicare & Medicaid Services June 6 to participate in a demonstration program under which they will pay primary care practices bonus payments to better coordinate care for their patients, CMS announced.